European Stroke Journal最新文献

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Author Index. 作者索引。
IF 5.8 3区 医学
European Stroke Journal Pub Date : 2025-06-01 Epub Date: 2025-06-20 DOI: 10.1177/23969873251330002
{"title":"Author Index.","authors":"","doi":"10.1177/23969873251330002","DOIUrl":"10.1177/23969873251330002","url":null,"abstract":"","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":"10 2_suppl","pages":"851-893"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictive value of follow-up infarct volume on functional outcomes in middle cerebral artery M2 segment vessel occlusion stroke treated with mechanical thrombectomy. 机械取栓术治疗大脑中动脉 M2 段血管闭塞中风随访梗死体积对功能预后的预测价值。
IF 5.8 3区 医学
European Stroke Journal Pub Date : 2025-06-01 Epub Date: 2024-09-13 DOI: 10.1177/23969873241275531
Vivek Yedavalli, Hamza Adel Salim, Basel Musmar, Nimer Adeeb, Kareem El Naamani, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kühn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Benjamin Yq Tan, Robert W Regenhardt, Jeremy J Heit, Nicole M Cancelliere, Joshua D Bernstock, Aymeric Rouchaud, Jens Fiehler, Sunil Sheth, Ajit S Puri, Christian Dyzmann, Marco Colasurdo, Xavier Barreau, Leonardo Renieri, João Pedro Filipe, Pablo Harker, Răzvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Thomas R Marotta, Julian Spears, Takahiro Ota, Ashkan Mowla, Pascal Jabbour, Arundhati Biswas, Frédéric Clarençon, James E Siegler, Thanh N Nguyen, Ricardo Varela, Amanda Baker, Muhammed Amir Essibayi, David Altschul, Nestor R Gonzalez, Markus A Möhlenbruch, Vincent Costalat, Benjamin Gory, Christian Paul Stracke, Mohammad Ali Aziz-Sultan, Constantin Hecker, Hamza Shaikh, David S Liebeskind, Alessandro Pedicelli, Andrea M Alexandre, Illario Tancredi, Tobias D Faizy, Erwah Kalsoum, Boris Lubicz, Aman B Patel, Vitor Mendes Pereira, Adrien Guenego, Adam A Dmytriw
{"title":"Predictive value of follow-up infarct volume on functional outcomes in middle cerebral artery M2 segment vessel occlusion stroke treated with mechanical thrombectomy.","authors":"Vivek Yedavalli, Hamza Adel Salim, Basel Musmar, Nimer Adeeb, Kareem El Naamani, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kühn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Benjamin Yq Tan, Robert W Regenhardt, Jeremy J Heit, Nicole M Cancelliere, Joshua D Bernstock, Aymeric Rouchaud, Jens Fiehler, Sunil Sheth, Ajit S Puri, Christian Dyzmann, Marco Colasurdo, Xavier Barreau, Leonardo Renieri, João Pedro Filipe, Pablo Harker, Răzvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Thomas R Marotta, Julian Spears, Takahiro Ota, Ashkan Mowla, Pascal Jabbour, Arundhati Biswas, Frédéric Clarençon, James E Siegler, Thanh N Nguyen, Ricardo Varela, Amanda Baker, Muhammed Amir Essibayi, David Altschul, Nestor R Gonzalez, Markus A Möhlenbruch, Vincent Costalat, Benjamin Gory, Christian Paul Stracke, Mohammad Ali Aziz-Sultan, Constantin Hecker, Hamza Shaikh, David S Liebeskind, Alessandro Pedicelli, Andrea M Alexandre, Illario Tancredi, Tobias D Faizy, Erwah Kalsoum, Boris Lubicz, Aman B Patel, Vitor Mendes Pereira, Adrien Guenego, Adam A Dmytriw","doi":"10.1177/23969873241275531","DOIUrl":"10.1177/23969873241275531","url":null,"abstract":"<p><strong>Background: </strong>Medium vessel occlusion (MeVO) strokes, particularly affecting the M2 segment of the middle cerebral artery, represent a critical proportion of acute ischemic strokes, posing significant challenges in management and outcome prediction. The efficacy of mechanical thrombectomy (MT) in MeVO stroke may warrant reliable predictors of functional outcomes. This study aimed to investigate the prognostic value of follow-up infarct volume (FIV) for predicting 90-day functional outcomes in MeVO stroke patients undergoing MT.</p><p><strong>Methods: </strong>This multicenter, retrospective cohort study analyzed data from the Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy (MAD-MT) registry, covering patients with acute ischemic stroke due to M2 segment occlusion treated with MT. We examined the relationship between 90-day functional outcomes, measured by the modified Rankin Scale (mRS), and follow-up infarct volume (FIV), assessed through CT or MRI within 12-36 h post-MT.</p><p><strong>Results: </strong>Among 130 participants, specific FIV thresholds were identified with high specificity and sensitivity for predicting outcomes. A FIV ⩽5 ml was highly specific for predicting favorable and excellent outcomes. The optimal cut-off for both prognostications was identified at ⩽15 ml by the Youden Index, with significant reductions in the likelihood of favorable outcomes observed above a 40 ml threshold. Receiver Operator Curve (ROC) analyses confirmed FIV as a superior predictor of functional outcomes compared to traditional recanalization scores, such as final modified thrombolysis in cerebral infarction score (mTICI). Multivariable analysis further highlighted the inverse relationship between FIV and positive functional outcomes.</p><p><strong>Conclusions: </strong>FIV within 36 h post-MT serves as a potent predictor of 90-day functional outcomes in patients with M2 segment MeVO strokes. Establishing FIV thresholds may aid in the prognostication of stroke outcomes, suggesting a role for FIV in guiding post intervention treatment decisions and informing clinical practice. Future research should focus on validating these findings across diverse patient populations and exploring the integration of FIV measurements with other clinical and imaging markers to enhance outcome prediction accuracy.</p>","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":" ","pages":"431-441"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endovascular treatment in patients with acute ischemic stroke presenting beyond 6 h after symptom onset: An international multicenter cohort study of the EVA-TRISP collaboration. 急性缺血性脑卒中患者症状出现 6 小时后的血管内治疗:EVA-TRISP合作组织的一项国际多中心队列研究。
IF 5.8 3区 医学
European Stroke Journal Pub Date : 2025-06-01 Epub Date: 2024-09-08 DOI: 10.1177/23969873241277437
Nabila Wali, Lotte J Stolze, Leon A Rinkel, Mirjam R Heldner, Madlaine Müller, Marcel Arnold, Pasquale Mordasini, Jan Gralla, Philipp Baumgartner, Corinne Inauen, Laura P Westphal, Susanne Wegener, Patrik Michel, Simon Trüssel, Laura Mannismäki, Nicolas Martinez-Majander, Sami Curtze, Georg Kägi, Livio Picchetto, Maria Luisa Dell'Acqua, Guido Bigliardi, Christoph Riegler, Christian H Nolte, Miguel Serôdio, Miguel Miranda, João Pedro Marto, Andrea Zini, Stefano Forlivesi, Luana Gentile, Carlo W Cereda, Alessandro Pezzini, Ronen R Leker, Asaf Honig, Ivana Berisavac, Visnja Padjen, Marialuisa Zedde, Laurien S Kuhrij, Renske M Van den Berg-Vos, Stefan T Engelter, Henrik Gensicke, Paul J Nederkoorn
{"title":"Endovascular treatment in patients with acute ischemic stroke presenting beyond 6 h after symptom onset: An international multicenter cohort study of the EVA-TRISP collaboration.","authors":"Nabila Wali, Lotte J Stolze, Leon A Rinkel, Mirjam R Heldner, Madlaine Müller, Marcel Arnold, Pasquale Mordasini, Jan Gralla, Philipp Baumgartner, Corinne Inauen, Laura P Westphal, Susanne Wegener, Patrik Michel, Simon Trüssel, Laura Mannismäki, Nicolas Martinez-Majander, Sami Curtze, Georg Kägi, Livio Picchetto, Maria Luisa Dell'Acqua, Guido Bigliardi, Christoph Riegler, Christian H Nolte, Miguel Serôdio, Miguel Miranda, João Pedro Marto, Andrea Zini, Stefano Forlivesi, Luana Gentile, Carlo W Cereda, Alessandro Pezzini, Ronen R Leker, Asaf Honig, Ivana Berisavac, Visnja Padjen, Marialuisa Zedde, Laurien S Kuhrij, Renske M Van den Berg-Vos, Stefan T Engelter, Henrik Gensicke, Paul J Nederkoorn","doi":"10.1177/23969873241277437","DOIUrl":"10.1177/23969873241277437","url":null,"abstract":"<p><strong>Introduction: </strong>After positive findings in clinical trials the time window for endovascular thrombectomy (EVT) for patients with an acute ischemic stroke has been expanded up to 24 h from symptom onset or last seen well (LSW). We aimed to compare EVT patients' characteristics and outcomes in the early versus extended time window and to compare outcomes with the DAWN and DEFUSE 3 trial results.</p><p><strong>Patients and methods: </strong>Consecutive EVT patients from 16 mostly European comprehensive stroke centers from the EVA-TRISP cohort were included. We compared rates of 90-day good functional outcomes (Modified Rankin Scale 0-2), symptomatic intracranial hemorrhage (sICH), and 90-day mortality between patients treated in the early (<6 h after onset or LSW) versus extended (6-24 h after onset or LSW) time windows.</p><p><strong>Results: </strong>We included 9313 patients, of which 6876 were treated in the early and 2437 in the extended time window. National Institutes of Health Stroke Scale (NIHSS) score at presentation was lower in patients treated in the extended time window (median 13 [IQR 7-18] vs 15 [IQR 9-19], <i>p</i> < 0.001). The percentage of patients with good functional outcome was slightly lower in the extended time window (37.4% vs 42.2%, <i>p</i> < 0.001). However, rates of successful recanalization, sICH, and mortality were similar. Good functional outcome rates after EVT were slightly lower for patients in the extended window in the EVA-TRISP cohort as compared to DAWN and DEFUSE 3.</p><p><strong>Discussion and conclusion: </strong>According to this large multicenter cohort study reflecting daily clinical practice, EVT use in the extended time window appears safe and effective.</p>","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":" ","pages":"422-430"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The presence of a ghost infarct core is associated with fast core growth in acute ischemic stroke. 在急性缺血性脑卒中中,幽灵梗死核心的存在与核心的快速生长有关。
IF 5.8 3区 医学
European Stroke Journal Pub Date : 2025-06-01 Epub Date: 2024-10-13 DOI: 10.1177/23969873241289320
Mikito Saito, Hiroyuki Kawano, Takuya Adachi, Miho Gomyo, Kenichi Yokoyama, Yoshiaki Shiokawa, Teruyuki Hirano
{"title":"The presence of a ghost infarct core is associated with fast core growth in acute ischemic stroke.","authors":"Mikito Saito, Hiroyuki Kawano, Takuya Adachi, Miho Gomyo, Kenichi Yokoyama, Yoshiaki Shiokawa, Teruyuki Hirano","doi":"10.1177/23969873241289320","DOIUrl":"10.1177/23969873241289320","url":null,"abstract":"<p><strong>Introduction: </strong>The overestimation of ischemic core volume by CT perfusion (CTP) is a critical concern in the selection of candidates for reperfusion therapy. This phenomenon is termed a ghost infarct core (GIC). Core growth rate (CGR) is an indicator of ischemic severity. We aimed to elucidate the association between GIC and CGR.</p><p><strong>Patients and methods: </strong>Consecutive patients with acute ischemic stroke who underwent mechanical thrombectomy in our institute from March 2017 to July 2022 were enrolled. The initial ischemic core volume (IICV) was measured by pretreatment CTP, and the final infarct volume (FIV) was measured by diffusion-weighted imaging. A GIC was defined by IICV minus FIV > 10 ml. The CGR was calculated by dividing the IICV by the time from onset to CTP. Univariable analysis and a multivariable logistic regression model were used to evaluate the association between GIC-positive and CGR.</p><p><strong>Results: </strong>Of all 91 patients, 21 (23.1%) were GIC-positive. The GIC-positive group had higher CGR (14.2 [2.6-46.7] vs 4.8 [1.6-17.1] ml/h, <i>p</i> = 0.02) and complete recanalization (<i>n</i> = 15 (71.4%) vs 29 (41.4%), <i>p</i> = 0.02) compared to the GIC-negative group. On receiver-operating characteristic curve analysis, the optimal cutoff point of CGR to predict GIC-positive was 22 ml/h (sensitivity, 0.48; specificity, 0.85; AUC, 0.67). Multivariable logistic regression analysis showed that CGR ⩾ 22 ml/h (OR 6.44, 95% CI [1.59-26.10], <i>p</i> = 0.01) and complete recanalization (OR 3.72, 95% CI [1.14-12.08], <i>p</i> = 0.02) were independent predictors of GIC-positive.</p><p><strong>Conclusions: </strong>A GIC was associated with fast CGR in acute ischemic stroke. Overestimation of the initial ischemic core may be determined by core growth speed.</p>","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":" ","pages":"487-494"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Stroke-heart syndrome and early mortality in patients with acute ischaemic stroke using hierarchical cluster analysis: An individual patient data pooled analysis from the VISTA database. 使用层次聚类分析法分析急性缺血性中风患者的中风-心脏综合征和早期死亡率:来自 VISTA 数据库的单个患者数据汇总分析。
IF 5.8 3区 医学
European Stroke Journal Pub Date : 2025-06-01 Epub Date: 2024-10-13 DOI: 10.1177/23969873241290440
Hironori Ishiguchi, Bi Huang, Wahbi K El-Bouri, Gregory Y H Lip, Azmil H Abdul-Rahim
{"title":"Stroke-heart syndrome and early mortality in patients with acute ischaemic stroke using hierarchical cluster analysis: An individual patient data pooled analysis from the VISTA database.","authors":"Hironori Ishiguchi, Bi Huang, Wahbi K El-Bouri, Gregory Y H Lip, Azmil H Abdul-Rahim","doi":"10.1177/23969873241290440","DOIUrl":"10.1177/23969873241290440","url":null,"abstract":"<p><strong>Background: </strong>The patient clinical phenotypes at particularly high risk for early cardiac complications after a recent acute ischaemic stroke (AIS), that is, stroke-heart syndrome (SHS), remain poorly defined. We utilised hierarchical cluster analysis to identify specific phenotypic profiles associated with this risk.</p><p><strong>Methods: </strong>We gathered data on patients with AIS from the Virtual International Stroke Trials Archive, a global repository of clinical trial data. We examined cardiac complications within 30 days post-stroke, including acute coronary syndrome, heart failure, arrhythmias and cardiorespiratory arrest. We employed hierarchical cluster analysis to define distinct phenotypic risk profiles. The incidence/risk of SHS and 90-day mortality were compared across these profiles.</p><p><strong>Results: </strong>We included 12,482 patients (mean age 69 ± 12 years; 55% male), yielding five phenotypes: Profile 1 ('<i>elderly and AF</i>'), Profile 2 ('<i>young and smoker</i>'), Profile 3 ('<i>young</i>'), Profile 4 ('<i>cardiac comorbidities</i>') and Profile 5 ('<i>hypertension with atherosclerotic comorbidities</i>'). Profiles 4 and 1 exhibited the highest risk for SHS (adjusted HR (95% CI): 2.01 (1.70-2.38) and 1.26 (1.05-1.51), respectively, compared to Profile 3), while Profiles 5 and 2 showed moderate risk and Profile 3 had the lowest risk. Although Profiles 1 and 4 were at the highest risk for most SHS presentations, Profile 5 had the highest risk for cardiorespiratory arrest (adjusted HR (95% CI): 2.99 (1.22-7.34)). The 90-day mortality risk was stratified by phenotype, with the highest risk observed in Profiles 5, and 4.</p><p><strong>Conclusions: </strong>Hierarchical cluster analysis effectively identified phenotypes with the highest risk of SHS and early mortality in patients with AIS.</p>","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":" ","pages":"478-486"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gadolinium leakage into ocular structures as a marker in stroke: A retrospective analysis of the WAKE-UP trial. 钆渗漏入眼结构作为中风的标志:WAKE-UP试验的回顾性分析。
IF 5.8 3区 医学
European Stroke Journal Pub Date : 2025-06-01 Epub Date: 2024-11-29 DOI: 10.1177/23969873241301276
Anke Wouters, Tim Van Assche, Lauranne Scheldeman, Bastian Cheng, Claus Ziegler Simonsen, Martin Ebinger, Norbert Nighoghossian, Keith W Muir, Matthias Endres, Jochen B Fiebach, Salvador Pedraza, Christian Gerloff, Vincent Thijs, Götz Thomalla, Robin Lemmens
{"title":"Gadolinium leakage into ocular structures as a marker in stroke: A retrospective analysis of the WAKE-UP trial.","authors":"Anke Wouters, Tim Van Assche, Lauranne Scheldeman, Bastian Cheng, Claus Ziegler Simonsen, Martin Ebinger, Norbert Nighoghossian, Keith W Muir, Matthias Endres, Jochen B Fiebach, Salvador Pedraza, Christian Gerloff, Vincent Thijs, Götz Thomalla, Robin Lemmens","doi":"10.1177/23969873241301276","DOIUrl":"10.1177/23969873241301276","url":null,"abstract":"<p><strong>Introduction: </strong>Blood-brain barrier disruption in acute ischemic stroke is a well described phenomenon associated with hemorrhagic complications. The hyperintense acute reperfusion marker (HARM) represents gadolinium leakage in the cerebrospinal fluid. Gadolinium leakage into ocular structures (GLOS) might represent a dysfunction of the blood-ocular barrier. We aimed to investigate the presence of GLOS in the WAKE-UP trial and its association with HARM, hemorrhagic transformation (HT) and functional outcome.</p><p><strong>Patients and methods: </strong>Randomized patients from the WAKE-UP trial who underwent dynamic susceptibility contrast perfusion weighted imaging at baseline and fluid attenuated inversion recovery (FLAIR) imaging at both baseline and follow-up, were included. We studied the association between GLOS with baseline and outcome variables.</p><p><strong>Results: </strong>We were able to analyze the data of 192/503 (38%) randomized WAKE-UP patients. GLOS was detected in 56 (29%) cases, four times more frequently than HARM (7%). GLOS positive patients were older (73 vs 65 years; <i>p</i> < 0.01), had a lower glomerular infiltration rate (GFR 79.5 vs 87.2 mL/min; <i>p</i> = 0.01), higher white matter hyperintensity volume (15.0 vs 9.9 mL; <i>p</i> < 0.01), less often presented with a large vessel occlusion (27% vs 44%; <i>p</i> = 0.02) and HARM was more often observed (9/56 vs 4/136; <i>p</i> = 0.01). In multivariable analysis the presence of GLOS was not associated with HT nor poor functional outcome (modified Rankin scale 3-6).</p><p><strong>Discussion and conclusion: </strong>GLOS is a relatively common finding in acute ischemic stroke patients and is associated with older age, worse renal function, increased white matter hyperintensity burden and HARM but not with HT or functional outcome.</p>","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":" ","pages":"524-530"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of smoke-free legislation on stroke risk: A systematic review and meta-analysis. 无烟立法对中风风险的影响:系统回顾与荟萃分析。
IF 5.8 3区 医学
European Stroke Journal Pub Date : 2025-06-01 Epub Date: 2024-10-30 DOI: 10.1177/23969873241293566
Zhuo Xun Chua, Chern Yeh Lai Amanda, Timothy Jia Rong Lam, Jamie Si Pin Ong, Shermane Yun Wei Lim, Shivaram Kumar, Mervyn Jun Rui Lim, Benjamin Yong Qiang Tan, Joel Aik, Andrew Fu Wah Ho
{"title":"Impact of smoke-free legislation on stroke risk: A systematic review and meta-analysis.","authors":"Zhuo Xun Chua, Chern Yeh Lai Amanda, Timothy Jia Rong Lam, Jamie Si Pin Ong, Shermane Yun Wei Lim, Shivaram Kumar, Mervyn Jun Rui Lim, Benjamin Yong Qiang Tan, Joel Aik, Andrew Fu Wah Ho","doi":"10.1177/23969873241293566","DOIUrl":"10.1177/23969873241293566","url":null,"abstract":"<p><strong>Purpose: </strong>Secondhand smoke significantly increases the risk of cerebrovascular diseases, prompting recent public smoking bans. We aimed to ascertain the effects of smoke-free legislation on stroke incidence and mortality.</p><p><strong>Methods: </strong>We systematically searched Medline, Embase, Cochrane Library, and Scopus up to August 13, 2023, for studies reporting changes in stroke incidence following partial or comprehensive smoking bans. A random-effects meta-analysis was conducted on hospital admissions and mortality for stroke, stratified based on comprehensiveness of the ban ((i) workplaces-only, (ii) workplaces and restaurants, (iii) workplaces, restaurants and bars). The effect of post-ban follow-up duration was assessed visually by a forest plot, while meta-regression was employed to evaluate for any dose-response relationship between ban comprehensiveness and stroke risk.</p><p><strong>Findings: </strong>Of 3987 records identified, 15 studies analysing bans across a median follow-up time of 24 months (range: 3-67) were included. WRB bans were associated with reductions in the rates of hospital admissions for stroke (nine studies; RR, 0.918; 95% CI, 0.872-0.967) and stroke mortality (three studies; RR, 0.987; 95% CI, 0.952-1.022), although the latter did not reach statistical significance. There was no significant difference in the risk of stroke admissions for studies with increased ban comprehensiveness and no minimum duration for significant post-ban effects to be observed.</p><p><strong>Discussion and conclusion: </strong>Legislative smoking bans were associated with significant reductions in stroke-related hospital admissions, providing evidence for its utility as a public health intervention.</p>","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":" ","pages":"350-361"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Antithrombotic drugs for carotid artery dissection: Updated systematic review. 治疗颈动脉夹层的抗血栓药物:最新系统综述。
IF 5.8 3区 医学
European Stroke Journal Pub Date : 2025-06-01 Epub Date: 2024-10-26 DOI: 10.1177/23969873241292278
Nikolaos S Avramiotis, Fabian Schaub, Sebastian Thilemann, Philippe Lyrer, Stefan T Engelter
{"title":"Antithrombotic drugs for carotid artery dissection: Updated systematic review.","authors":"Nikolaos S Avramiotis, Fabian Schaub, Sebastian Thilemann, Philippe Lyrer, Stefan T Engelter","doi":"10.1177/23969873241292278","DOIUrl":"10.1177/23969873241292278","url":null,"abstract":"<p><strong>Introduction: </strong>Extracranial internal carotid artery dissection (eICAD) is a leading cause of stroke in younger patients. In this Cochrane Review update we compared benefits and harms of eICAD-patients treated with either antiplatelets or anticoagulants.</p><p><strong>Patients and methods: </strong>Eligible studies were identified through Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, and EMBASE and personal search until December 2023. We included randomized-controlled trials (RCTs) and non-randomized studies comparing anticoagulants with antiplatelets in eICAD-patients. Co-primary outcomes were (i) death (all causes) and (ii) death or disability. Secondary outcomes were ischemic stroke, symptomatic intracranial hemorrhage, and major extracranial hemorrhage. Odds ratios (OR) with 95% CIs were calculated for (i) all studies and (ii) separately for RCTs and non-randomized studies.</p><p><strong>Results: </strong>We meta-analyzed a total of 42 studies (2624 patients) including 2 RCTs (213 patients) for the primary outcome of death and 31 studies (1953 patients) including 1 RCT (115 patients) for the primary outcome of death or disability. Antiplatelet-treated patients had higher odds for death (OR<sub>all-studies</sub> 2.70, 95% CI 1.27-5.72; OR<sub>RTCs</sub> 6.80, 95% CI 0.14-345; OR<sub>non-randomized studies</sub> 2.60, 95% CI 1.20-5.60) and death or disability (OR<sub>all-studies</sub> 2.1, 95% CI 1.58-2.66; OR<sub>RTCs</sub> 2.2, 95% CI 0.29-16.05; OR<sub>non-randomized studies</sub> 2.1, 95% CI 1.58-2.66) than anticoagulated patients. Antiplatelet-treated patients had also higher odds for ischemic stroke, though this reached statistical significance only in the subgroup of RCTs (OR<sub>RTC</sub> 4.60, 95% CI 1.36-15.51). In turn, antiplatelet-treated patients had less symptomatic intracranial hemorrhage (OR<sub>all-studies</sub> 0.25, 95% CI 0.07-0.86) and a tendency toward less major extracranial hemorrhage (OR<sub>all-studies</sub> 0.17, 95% CI 0.03-1.03).</p><p><strong>Discussion and conclusion: </strong>The evidence considering antiplatelets as standard of care in eICAD is weak. Individualized treatment decisions balancing risks versus harms seem recommendable.</p>","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":" ","pages":"339-349"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
11th European Stroke Organisation Conference Abstracts - 21-23 May 2025, Helsinki, Finland: Late Breaking Abstracts. 第11届欧洲中风组织会议摘要- 2025年5月21-23日,芬兰赫尔辛基:最新摘要。
IF 4.5 3区 医学
European Stroke Journal Pub Date : 2025-06-01 Epub Date: 2025-06-20 DOI: 10.1177/23969873251345751
{"title":"11th European Stroke Organisation Conference Abstracts - 21-23 May 2025, Helsinki, Finland: Late Breaking Abstracts.","authors":"","doi":"10.1177/23969873251345751","DOIUrl":"10.1177/23969873251345751","url":null,"abstract":"","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":"10 2_suppl","pages":"790-850"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk factors for intracerebral hemorrhage by five specific bleeding sites: Japan Public Health Center-based Prospective Study. 按五个特定出血部位划分的脑内出血风险因素:日本公共卫生中心前瞻性研究。
IF 5.8 3区 医学
European Stroke Journal Pub Date : 2025-06-01 Epub Date: 2024-10-17 DOI: 10.1177/23969873241290680
Kenichi Ariyada, Kazumasa Yamagishi, Tomomi Kihara, Isao Muraki, Hironori Imano, Yoshihiro Kokubo, Isao Saito, Hiroshi Yatsuya, Hiroyasu Iso, Shoichiro Tsugane, Norie Sawada
{"title":"Risk factors for intracerebral hemorrhage by five specific bleeding sites: Japan Public Health Center-based Prospective Study.","authors":"Kenichi Ariyada, Kazumasa Yamagishi, Tomomi Kihara, Isao Muraki, Hironori Imano, Yoshihiro Kokubo, Isao Saito, Hiroshi Yatsuya, Hiroyasu Iso, Shoichiro Tsugane, Norie Sawada","doi":"10.1177/23969873241290680","DOIUrl":"10.1177/23969873241290680","url":null,"abstract":"<p><strong>Background: </strong>Evaluating the risk factors for intracerebral hemorrhage is indispensable for primary prevention. However, the pathogenesis varies depending on the bleeding site, and few prospective studies have explored risk factors in detail for each site.</p><p><strong>Participants and methods: </strong>The Japan Public Health Center-based Prospective Study is a prospective study comprising a population-based sample of Japanese adults in 1990 (Cohort I) and in 1993 (Cohort II). A total of 34,137 participants (11,907 men and 22,230 women) were enrolled in this study and followed up until 2009 for Cohort I and until 2012 for Cohort II. The association between risk factors (age, sex, blood pressure, serum cholesterol, triglycerides, blood glucose, body mass index, smoking, and drinking status) and intracerebral hemorrhage by its bleeding site (lobes, putamen, thalamus, cerebellum, and brainstem) was assessed using Cox proportional hazards analysis.</p><p><strong>Results: </strong>During a median 20-year follow-up, 571 intracerebral hemorrhage events occurred. Hypertension was associated with an increased risk of total intracerebral hemorrhage, but not lobar hemorrhage. The multivariable hazard ratio (95% confidence intervals) was 2.09 (1.75-2.50) for total intracerebral hemorrhage. In contrast, a low serum total cholesterol level was associated only with lobar hemorrhage (1.73 (1.01-2.96)). Heavy drinking was associated with the risk of total and putamen hemorrhage, and obesity was associated with the risk of putamen hemorrhage.</p><p><strong>Discussion and conclusion: </strong>The present study identified different risk factors depending on the bleeding site of intracerebral hemorrhage.</p>","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":" ","pages":"600-609"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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